Provider Demographics
NPI:1487726188
Name:JANOS, BRYAN M (DDS)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:M
Last Name:JANOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3932 FORT BLVD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930
Mailing Address - Country:US
Mailing Address - Phone:915-566-9415
Mailing Address - Fax:915-566-9415
Practice Address - Street 1:3932 FORT BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930
Practice Address - Country:US
Practice Address - Phone:915-566-9415
Practice Address - Fax:915-566-9415
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice